恶性肿瘤患者气管插管全麻术后并发肺部感染的危险因素分析

目的探讨恶性肿瘤患者气管插管全麻术后并发肺部感染的危险因素。方法根据气管插管全麻术后是否并发肺部感染将317例恶性肿瘤患者分为肺部感染组(32例)与非肺部感染组(285例)。收集研究对象临床资料,先采用单因素χ2检验筛选有统计意义的指标,然后再采用多因素非条件Logistic回归分析模型分析术后并发肺部感染的危险因素。结果①单因素χ2检验显示,2组患者性别、体质指数(BMI)、手术时限性、合并贫血、合并低白蛋白血症等差异无统计学意义(P>0.05),而年龄、插管方式、插管途径、插管深度、插管指征、拔管延迟、气管导管留置时间、全麻时间、合并慢性阻塞性肺疾病(COPD)、吸烟史差异有统计学意义(P<0.05)。②多因素非条件Logistic回归分析显示,年龄、插管方式、插管深度、插管指征、拔管延迟、气管导管留置时间、全麻时间、合并COPD、吸烟史是术后并发肺部感染的独立危险因素(P<0.05)。结论严格掌握气管插管全麻指征,规范管理气管插管与麻醉复苏拔管过程,充分做好患者术前准备,可降低恶性肿瘤患者气管插管全麻术后肺部感染发生率。

Risk Factors of Pulmonary Infection after Tracheal Intubation General Anesthesia in Patients with Malignant Tumors

Objective To investigate the risk factors of pulmonary infection after tracheal intubation general anesthesia in patients with malignant tumors.Methods 317 patients with malignant tumors were divided into pulmonary infection group(32 cases)and non-pulmonary infection group(285 cases)according to whether complicating with pulmonary infection after tracheal intubation general anesthesia or not.The clinical data of all subjects were collected.The statistical significance indexes were screened by single-factor chi-square test,then the multi-factor unconditional Logistic regression analysis model was used.Results①The single-factor chi-square test showed,no significant differences were found in the gender,body mass index(BMI),operation time limit,anemia and hypoalbuminemia between the 2 groups(P>0.05),while there were significant differences in the age,intubation mode,intubation route,intubation depth,intubation indication,extubation delay,indwelling time of tracheal tube,general anesthesia time,COPD and smoking history between the 2 groups(P<0.05).②The multi-factor unconditional Logistic regression analysis showed,the age,intubation mode,intubation depth,intubation indication,extubation delay,delayed extubation,indwelling time of tracheal tube,general anesthesia time,COPD and smoking history were independent risk factors for pulmonary infection(P<0.05).Conclusion Strictly grasping the indications of general anesthesia with tracheal intubation,managing the process of tracheal intubation and anesthesia resuscitation extubation,and fully preparing the patients before operation can reduce the incidence of pulmonary infection in patients with malignant tumors after tracheal intubation general anesthesia.